Definition

What is chronic fatigue syndrome?

Chronic fatigue syndrome (CFS) is a complicated disorder characterized by extreme fatigue that can’t be explained by any underlying medical condition. The fatigue may worsen with physical or mental activity, but doesn’t improve with rest. It lasts a long time and limits your ability to do ordinary daily activities.

CFS can also be referred to as myalgic encephalomyelitis (ME) or systemic exertion intolerance disease (SEID). Although CFS/ME and SEID share the same major symptom of chronic fatigue, there is variation between the definitions of these disorders. The symptom of chronic fatigue also may arise from more than one underlying condition.

The causes of CFS aren’t well-understood. Some theories include viral infection, psychological stress, or a combination of factors. Because no single cause has been identified, and because many other illnesses produce similar symptoms, CFS can be difficult to diagnose. There are no tests for CFS, so your doctor will have to rule out other causes for your fatigue.

How common is Chronic Fatigue Syndrome?

Chronic Fatigue Syndrome commonly affects more females than males. It can affect patients at any age. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of chronic fatigue syndrome?

Chronic fatigue syndrome has eight official signs and symptoms, plus the central symptom that gives the condition its name:

Pain that moves from one joint to another without swelling or redness;

Headache of a new type, pattern or severity;

Unrefreshing sleep;

Extreme exhaustion lasting more than 24 hours after physical or mental exercise.

People are sometimes affected by CFS in cycles, with periods of feeling worse and then better again. Symptoms may sometimes even disappear completely (remission). However, it’s still possible for them to come back again later (relapse). The cycle of remission and relapse can make it difficult to manage your symptoms.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Fatigue can be a symptom of many illnesses, such as infections or psychological disorders. In general, see your doctor if you have persistent or excessive fatigue.

Causes

What causes chronic fatigue syndrome?

Scientists don’t know exactly what causes chronic fatigue syndrome. It may be a combination of factors that affect people who were born with a predisposition for the disorder.

Some of the factors that have been studied include:

Viral infections: Because some people develop chronic fatigue syndrome after having a viral infection, researchers question whether some viruses might trigger the disorder. Suspicious viruses include Epstein-Barr virus, human herpes virus 6 and mouse leukemia viruses. No conclusive link has yet been found.

Immune system problems: The immune systems of people who have chronic fatigue syndrome appear to be impaired slightly, but it’s unclear if this impairment is enough to actually cause the disorder.

Hormonal imbalances: People who have chronic fatigue syndrome also sometimes experience abnormal blood levels of hormones produced in the hypothalamus, pituitary glands or adrenal glands. But the significance of these abnormalities is still unknown.

Risk factors

What increases my risk for chronic fatigue syndrome?

There are many risk factors for chronic fatigue syndrome, such as:

Age: Chronic fatigue syndrome can occur at any age, but it most commonly affects people in their 40s and 50s.

Sex: Women are diagnosed with chronic fatigue syndrome much more often than men, but it may be that women are simply more likely to report their symptoms to a doctor.

Stress: Difficulty managing stress may contribute to the development of chronic fatigue syndrome.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is chronic fatigue syndrome diagnosed?

There’s no single test to confirm a diagnosis of chronic fatigue syndrome. The reason is that the symptoms of chronic fatigue syndrome can mimic so many other health problems, you may need patience while waiting for a diagnosis.

Your doctor must rule out a number of other illnesses before diagnosing chronic fatigue syndrome. These may include:

Sleep disorders: Chronic fatigue can be caused by sleep disorders. A sleep study can determine if your rest is being disturbed by disorders such as obstructive sleep apnea, restless legs syndrome or insomnia.

Medical problems: Fatigue is a common symptom in several medical conditions, such as anemia, diabetes and underactive thyroid (hypothyroidism). Lab tests can check your blood for evidence of some of the top suspects.

Mental health issues: Fatigue is also a symptom of a variety of mental health problems, such as depression, anxiety, bipolar disorder and schizophrenia. A counselor can help determine if one of these problems is causing your fatigue.

To meet the diagnostic criteria of chronic fatigue syndrome, or myalgic encephalomyelitis, you must have unexplained, persistent fatigue for six months or more, along with at least four of the following signs and symptoms:

Pain that moves from one joint to another without swelling or redness;

Headache of a new type, pattern or severity;

Unrefreshing sleep;

Extreme exhaustion lasting more than 24 hours after physical or mental exercise.

In contrast, for a diagnosis of systemic exertion intolerance disease (SEID), you must have the following three symptoms:

Unexplained, persistent fatigue;

Extreme exhaustion lasting more than 24 hours after physical or mental exercise;

Unrefreshing sleep.

And at least one of these two symptoms:

Cognitive impairment;

Dizziness and lightheadedness.

Chronic fatigue accompanies many medical conditions and may not be an isolated symptom. In such cases, the better term may be “chronic multifactorial fatigue.”

How is chronic fatigue syndrome treated?

Due to the fact that chronic fatigue syndrome affects people in many different ways, your treatment will be tailored to your specific set of symptoms. Symptom relief may include certain medications:

Antidepressants: Many people who have chronic fatigue syndrome are also depressed. Treating your depression can make it easier for you to cope with the problems associated with chronic fatigue syndrome. Low doses of some antidepressants also can help improve sleep and relieve pain.

Sleeping pills: If home measures, such as avoiding caffeine, don’t help you get better rest at night, your doctor might suggest trying prescription sleep aids.

There’s no known cure for chronic fatigue syndrome, and the most effective treatment for chronic fatigue syndrome remains uncertain. However, there’s evidence that a multipronged approach may be helpful:

Pace yourself: Keep your activity on an even level. If you do too much on your good days, you may have more bad days.

Graded exercise: In order to improve daily function, more than pacing alone is needed. Previous studies suggest that graded exercise is an effective and safe treatment, but evidence for this remains limited. A physical therapist can help determine what types of exercise are best for you. Inactive people often begin with range-of-motion and stretching exercises for just a few minutes a day. Slow, incremental increases in activity then take place over weeks to months. If you’re exhausted the next day, you’re doing too much. Your strength and endurance will improve as you gradually increase the intensity of your exercise over time.

Psychological counseling: Talking with a counselor can help you figure out options to work around some of the limitations that chronic fatigue syndrome imposes on you. Feeling more in control of your life can improve your outlook dramatically. Cognitive behavioral therapy and self-management strategies are among the most helpful.

Not everyone who has severe chronic fatigue and post-exertional malaise — intense exhaustion or mental fatigue after physical or mental activities that were once tolerated — responds to treatment in the same way. People who have a better chance of treatment success tend to have less impairment, focus less on symptoms, comply with counseling programs and pace themselves to avoid overexertion and under-exertion.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage chronic fatigue syndrome?

The following lifestyles and home remedies might help you cope with chronic fatigue syndrome:

Reduce stress: Develop a plan to avoid or limit overexertion and emotional stress. Allow yourself time each day to relax. That may mean learning how to say no without guilt.

Improve sleep habits: Go to bed and get up at the same time each day. Limit daytime napping and avoid caffeine, alcohol and nicotine.

Pace yourself: Keep your activity on an even level. If you do too much on your good days, you may have more bad days.

Many alternative therapies have been promoted for chronic fatigue syndrome. It’s difficult to determine whether these therapies actually work, partly because the symptoms of chronic fatigue syndrome often are linked to mood and can vary from day to day. Pain associated with chronic fatigue syndrome may be helped by:

Acupuncture;

Massage;

Yoga or tai chi.

If you have any questions, please consult with your doctor to better understand the best solution for you.